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Galantamine for Alzheimer's disease.
1Adult and Geriatric Treatment and Preventative Interventions Branch, National Institute of Mental Health, NIMH, Room 7160, MSC 9635, 6001 Executive Blvd., Bethesda, Maryland 20892-9635, USA. jolin@mail.nih.gov
The Cochrane Database of Systematic Reviews
|May 2, 2001
Summary
Galantamine demonstrates significant treatment effects for Alzheimer's disease at daily doses of 16-32 mg/d over 3-6 months. Higher doses showed improvements in global ratings and cognitive function, though with increased discontinuation rates.
Area of Science:
- Pharmacology and Neurology
- Clinical Trials and Therapeutics
Background:
- Galantamine, an acetylcholinesterase inhibitor and nicotinic receptor modulator, is synthesized and used for Alzheimer's disease.
- Previous studies suggested mild cognitive benefits; recent multicentre trials show positive findings, leading to regulatory approvals in some regions.
Purpose of the Study:
- To assess the clinical effects of galantamine in patients with probable Alzheimer's disease.
- To investigate potential moderators of galantamine's treatment effect.
Main Methods:
- Systematic review of randomized, double-blind, parallel-group trials comparing galantamine with placebo for over 4 weeks.
- Searched multiple databases (Cochrane, EMBASE, MEDLINE, etc.) and clinical trial registers.
- Extracted and pooled data on cognitive (ADAS-cog), global (CIBIC-plus), and functional (ADCS-ADL, DAD) outcomes; analyzed trial duration and dose as moderators.
Main Results:
- Galantamine showed significant treatment effects at daily doses of 16-32 mg/d over 3-6 months.
- Significant improvements in global ratings and cognitive function (ADAS-Cog) were observed at doses of 24-32 mg/d for 6 months.
- Higher doses (24-32 mg/d) were associated with increased trial discontinuation rates, unlike lower doses or placebo.
Conclusions:
- Galantamine at 16-32 mg/d is effective for probable Alzheimer's disease over 3-6 months.
- Dose and trial duration are key factors influencing treatment efficacy and tolerability.
- Further research is needed to optimize dosing and minimize adverse effects like gastrointestinal issues and discontinuation.